Motivation to quit using cigarettes: A review☆
Section snippets
Method
To search the literature, we used combinations of key terms. The primary terms (with iterations in parentheses) were as follows: tobacco (smoker, smoking), cessation (quit, quit attempts, self-quitter, intentions to quit, motivation to quit), motivation (consciousness-raising), intervention (hospital, community, workplace, media), health events (myocardial infarction, pregnancy, cardiopulmonary disease and cardiovascular disease, cancer, emphysema), health professional (doctor, dentist, nurse),
Retrospective reports of ex-smokers
Some researchers have queried ex-smokers about why they quit. Such reports must be treated cautiously for several reasons. First, because the reports are retrospective, ex-smokers may have difficulty recalling what initially motivated their behavior. Second, ex-smokers may be unaware of precisely why they decided to quit; access to cognitive processes such as motives is imperfect (Nisbett & Wilson, 1977). Finally, as is always true of self-reports, inaccuracies may appear because some
Cross-sectional surveys of current smokers
Compared to retrospective studies, cross-sectional surveys have one major advantage: Memory is not a problem. In a cross-sectional study, current smokers are asked if they would like to quit smoking, and–if so–why. The problem with these data, of course, is that we do not know which motives actually predict a future quit attempt; we can only learn from these studies whether different motives correlate with contemporaneous plans to quit. Still, intentions predict smoking behavior (e.g., Norman,
Prospective studies of smokers in cessation studies
In these studies, current smokers say why they would like to quit, and the researchers then follow them to determine whether they actually do so. Prospective designs redress some methodological issues, but it is important to note two possible problems in the prospective data we uncovered. First, half of the studies in this section are treatment studies, and it is conceivable that some treatments would interact with cessation motivations to determine abstinence. Second, smokers who volunteer for
Discussion
We began this review by asking the question, “What motivates smokers to quit?” The answer is clear: They are concerned about the health consequences of their smoking. This conclusion was supported strongly and consistently across all three literatures: (a) ex-smokers reported that they quit to protect their health, (b) current smokers who wished to quit said health concern was driving their desire, and (c) smokers in prospective cessation studies said they were quitting to protect their health.
Conclusions
Most smokers who have quit or who are thinking about doing so are concerned about health. Thus, we suggest that continuing to emphasize the health risks of smoking both in one-to-one contacts and in public health messages should maintain and increase the motivation of current smokers to try abandoning the habit. In closing, it is also important to recognize that many of the ideas in this paper, though they come largely from a long accumulation of empirical findings, have been espoused by
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We thank Amy Canevello and Tanna Richard for helping with the literature review. Work on this paper was supported by grants R01 CA77756, K05 CA92633, and R21 CA098962 from the National Cancer Institute.